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Health Decision Making SIG Explores what Makes a 'Good' Health Decision
Christine Rini, PhD, Health Decision Making SIG co-chair and Outlook liaison
People are increasingly faced with the need to become actively involved in making health decisions that are challenging for various reasons. For instance, they may face treatment decisions with no evidence-based “right” choice, decisions about screening tests with the potential to cause harms such as unnecessary treatments, or decisions about whether and how to protect their future health with lifestyle changes. These and other health decisions are of broad interest to Society of Behavioral Medicine (SBM) members within and outside of the society’s Health Decision Making Special Interest Group (HDM SIG).
SBM members are learning about how people make health decisions, and they are developing new methods for helping patients make good decisions. The goal of this ambitious endeavor is deceptively simple: Determine how best to engage patients in making satisfying health care choices that increase the likelihood that they will realize meaningful outcomes. However, in reality, embracing this mission requires us to consider or influence a complex set of intrapersonal, interpersonal, and contextual factors. It also requires us to address some fundamental questions: What is a good decision making process? What is a good decision making outcome? How can you tell when your efforts have “succeeded” in helping someone make a good decision? SBM’s HDM SIG is planning events that will tackle these questions and related aspects of health decision making at the upcoming SBM Annual Meeting & Scientific Sessions to be held in San Antonio, TX, from April 22-25, 2015.
In any health decision, the individuals who are involved have their own perspectives on what constitutes the best choice. Practitioners are typically interested in promoting empirically- or clinically-tested options that are most likely to lead to the best clinical outcomes for their patients. Policy professionals must balance the potential for societal benefit against the potential for chosen treatments to strain an already over-burdened health system. Behavioral decision scientists investigate factors that influence the extent to which people made preference-sensitive decisions that were consistent with their personal values and were based on accurate information. Scientists also investigate whether such decisions were difficult to make (e.g., due to decisional conflict), and if—once made and acted upon—they caused decision regret, poor quality of life, impaired ability to pursue valued life goals, or other adverse outcomes. Less often, scientists consider outcomes beyond individual patients, such as effects on the family system. In real life, patients’ health decisions are often far more complex than current theories help us to understand and predict. Furthermore, too often patients must make decisions despite having poor access to high-quality information, or they have difficulty understanding, remembering, and applying the information they get.
These complexities are just some of the reasons SBM members and the HDM SIG are drawn to research on this fascinating topic. In fact, we would like to highlight an interactive, cross-disciplinary workshop organized for our San Antonio meeting by a committee made up of SBM and Society of Medical Decision Making (SMDM) members (Dana Alden, Jada Hamilton, Megan Oser, Christine Rini, Laura Scherer, and Erika Waters). This workshop will feature representatives of key stakeholder groups with differing perspectives of health decision making, including: physicians (Robert Jacobson), patients (Brian Zikmund-Fisher), decision scientists (Ronald Myers), and health insurance providers (John Baleix). They will describe their perspectives on “good” health decisions in the context of three case studies of difficult decisions, interacting with the audience. The HDM SIG will soon be announcing other health decision making events for the upcoming Annual Meeting, as well. We look forward to seeing you in San Antonio!